Premature loss of primary molars can cause a number of undesirable consequences including loss of arch length, insufficient space for erupting premolars and mesial tipping of the permanent molars.
Pulpectomy of primary molar teeth is considered as a reasonable treatment approach to ensure either normal shedding or a long-term survival in instances of retention.
Despite being a more conservative treatment option than extraction, efficient pulpectomy of bizarre and tortuous root canals encased in roots programmed for physiologic resorption that show close proximity to developing permanent tooth buds presents a critical endodontic challenge.
This article aims to provide an overview of this treatment approach, including partial and total pulpectomy, in primary molar teeth.
In addition, the recommended guidelines that should be followed, and the current updates that have been developed, while commencing total pulpectomy in primary molars are discussed.
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The main objective of pulp therapy in the primary dentition is to retain every primary tooth as a fully functional component in the dental arch to allow for proper mastication, phonation, swallowing, preservation of the space required for eruption of permanent teeth and prevention of detrimental psychological effects due to tooth loss.
To fulfill this major goal, vital pulp therapy through pulpotomy, which refers to surgical removal of the entire coronal inflamed pulp leaving the vital radicular pulp intact within the canals, is the most widely accepted technique for treating primary teeth with irreversible inflammation affecting the pulp chamber.
However, in cases of irreversibly inflamed and necrotic radicular canals, a successful pulpotomy cannot be achieved, and a partial or total pulpectomy is indicated.
Hany Mohamed Aly Ahmed